Healthcare Provider Details

I. General information

NPI: 1336136027
Provider Name (Legal Business Name): INGRID MARIA ALLARD MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/29/2005
Last Update Date: 11/30/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19 BRADHURST AVE SUITE 1400
HAWTHORNE NY
10532-2140
US

IV. Provider business mailing address

22 SAW MILL RIVER RD
HAWTHORNE NY
10532-1533
US

V. Phone/Fax

Practice location:
  • Phone: 914-593-8850
  • Fax: 914-594-3747
Mailing address:
  • Phone: 914-593-1710
  • Fax: 914-593-1790

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number182434
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: